Minimizing Stigma, Improving Care: An Investigation into Empathy and Narrative for Understanding the Lived Experience of Schizophrenia

This dissertation explores a phenomenological account of empathy and narrative-based medicine. Its objective is to offer a sustained critical discussion of the benefits of a phenomenological account of empathy and narrative-based medicine for understanding the experiences of persons diagnosed with schizophrenia, improving therapeutic relationships, minimizing the stigma of mental illness, and supporting people with schizophrenia in their recovery.

Part one of this dissertation critically examines the nature of empathy and highlights the challenges that impede our ability to understand the experiences of persons with schizophrenia. Schizophrenia has historically been viewed as a condition which defies empathic understanding. This view, endorsed by Karl Jaspers, has been influential in shaping current depictions of schizophrenia in Anglo-American medical literature and informing how clinicians interact with those who are diagnosed with this condition. The dissertation makes the argument that Jaspers' approach is limited and sets the theoretical basis for a more robust account of empathy in the conceptualization of relations with persons with schizophrenia.

Part two of this dissertation defends a phenomenological account of empathy, developed by Edith Stein, and presents it as an alternative to simulation theories of empathy. Simulation theories of empathy involve using one's own cognitive resources to replicate the experiences and mental states of others by imagining being in their situation. But one problem with this approach is that it runs the risk of co-opting their experiences and substituting our own, which is morally problematic. In response, Stein's theory offers a solution by recognizing that empathy involves appreciating someones experiences as it is for them and thus it avoids the assimilation of the experiences of others.

Part three of this dissertation explores applications of Stein's theory of empathy and examines narrative-based medicine as a model of therapy. The narratives of persons with schizophrenia offer crucial insight into their lived experience of illness. By engaging with the lived experiences and narratives of others, caregivers can learn improved ways of understanding and supporting people diagnosed with schizophrenia as they restore a sense of self that has been harmed due to the effects of stigma that portray mental illness negatively.